ENDO: Bone Resorption Extremely Sensitive To Low Estradiol Levels In Anorexia Nervosa
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ENDO: Bone Resorption Extremely Sensitive To Low Estradiol Levels In Anorexia Nervosa

By Amy Lazarus Yaroch
Special to DG News

DENVER, CO -- June 24, 2001 -- Very low concentrations of serum estradiol are needed to improve catabolic bone metabolism in patients with anorexia nervosa.

Dr. Mari Hotta with Tokyo Women’s Medical University, Japan, reported findings yesterday (June 23) at the 83rd Annual Meeting of the Endocrine Society (ENDO) in Denver, Colorado.

Estrogen deficiency, which is the main symptom of anorexia nervosa, is characterized by bone resorption, decrease in bone formation, and subsequent osteoporosis, and is a serious threat to patients with the condition, according to researchers.

They studied 62 Japanese women with amenorrhea, age 18-34 years with body mass indices (BMI’s) ranging from 9.6 - 22.8 kg/m2. Using a very sensitive assay, they measured levels of serum estradiol in these patients.

“Serum estradiol levels decreased to less than 10 pg/mL in 29 patients and were undetected in five patients, researchers explain. Serum estradiol levels were positively correlated with BMI (r = 0.77, P < 0.0001).

"Only a very low concentration of serum estradiol (1.36 - 3 pg/mL) is needed for inhibiting bone resorption and improving bone metabolism," Dr. Hotta told Doctor’s Guide. "The estradiol level sufficient for normalization of bone metabolism lies between 7 and 9 pg/mL."

These findings have important implications for estrogen replacement therapy in patients with anorexia nervosa. Dr. Hotta advised Doctor’s Guide, "Physicians should try to use very low doses of estrogen in treating severely emaciated anorexia nervosa patients."

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